title: Limited role for surveillance PET-CT scanning in patients with diffuse large B-cell lymphoma in complete metabolic remission following primary therapy.
abstract: BACKGROUND
  The usefulness of positron emission tomography with computed tomography (PET-CT) in the surveillance of patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission after primary therapy is not well studied.
  
  
  METHODS
  We performed a retrospective review of our database between 2002 and 2009 for patients with de novo DLBCL who underwent surveillance PET-CT after achieving complete metabolic response (CMR) following primary therapy.
  
  
  RESULTS
  Four-hundred and fifty scans were performed in 116 patients, with a median follow-up of 53 (range 8-133) months from completion of therapy. Thirteen patients (11%) relapsed: seven were suspected clinically and six were subclinical (all within first 18 months). The positive predictive value in patients with international prognostic index (IPI) <3 was 56% compared with 80% in patients with IPI ≥3. Including indeterminate scans, PET-CT retained high sensitivity 95% and specificity 97% for relapse.
  
  
  CONCLUSIONS
  Positron emission tomography with computed tomography is not useful in patients for the majority of patients with diffuse large B-cell lymphoma in CMR after primary therapy, with the possible exception of patients with baseline IPI ≥3 in the 18 months following completion of primary therapy. This issue could be addressed by a prospective clinical trial.
authors.affiliation: Department of Haematology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
authors.forename: C Y
authors.initials: CY
authors.lastname: Cheah
authors.forename: M S
authors.initials: MS
authors.lastname: Hofman
authors.forename: M
authors.initials: M
authors.lastname: Dickinson
authors.forename: A
authors.initials: A
authors.lastname: Wirth
authors.forename: D
authors.initials: D
authors.lastname: Westerman
authors.forename: S J
authors.initials: SJ
authors.lastname: Harrison
authors.forename: K
authors.initials: K
authors.lastname: Burbury
authors.forename: M
authors.initials: M
authors.lastname: Wolf
authors.forename: H
authors.initials: H
authors.lastname: Januszewicz
authors.forename: K
authors.initials: K
authors.lastname: Herbert
authors.forename: H M
authors.initials: HM
authors.lastname: Prince
authors.forename: D A
authors.initials: DA
authors.lastname: Carney
authors.forename: D S
authors.initials: DS
authors.lastname: Ritchie
authors.forename: R J
authors.initials: RJ
authors.lastname: Hicks
authors.forename: J F
authors.initials: JF
authors.lastname: Seymour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods* / Q000706:statistics & numerical data; D064847:Multimodal Imaging / Q000379:methods* / Q000706:statistics & numerical data; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor